A cross-sectional study to evaluate access to antenatal care services in Twifo Hemang Lower Denkyira district of Ghana

Abstract

AbstractBackgroundAntenatal care (ANC) which is an essential component of the reproductive, maternal, newborn, and child health continuum of care is found to positively correlate with supervised delivery and the reduction of maternal deaths. In Ghana, few studies have explored how ANC is influenced by the community-based health planning and services (CHPS) policy, and in the Central Region, evidence is non-existent. This study aimed to determine factors that influence access to ANC services provided through the CHPS policy in the Twifo Hemang Lower Denkyira district in the Central Region of Ghana.MethodsA cross-sectional study examined 310 women aged 15-49 years, having children less than 12 months, and interviewed using a structured questionnaire. Univariate and multivariate logistic regression analyses were conducted using STATA 17 and results were reported as odds ratios at a confidence level of 95%.ResultsANC coverage and proportion of early ANC initiation were 93.9% and 69.1% respectively.Being unmarried (AOR=0.125, 95%CI=0.012,0.926), and home delivery (AOR=0.013; 95%CI: 0.001,0.176) were associated with decreased odds of at least one ANC visit during pregnancy. Larger (≥11) household size (AOR=3.848; 95%CI=1.914,16.21), lesser (<4) ANC contacts (AOR=6.332; 95%CI=2.049,19.57), and home visitation by CHPS staff (AOR=1.813; 95%CI=1.014,3.243) were associated with higher odds of late ANC initiation while average monthly income (AOR=0.123; 95%CI=0.024,0.630) was associated with reduced odds of late ANC initiation. Interestingly, knowledge about ANC and pregnancy, and geographical variables like receiving ANC services from CHPS zones, and distance to CHPS zones were not statistically significant with either ANC attendance or time of ANC initiation after controlling for the effect of other variables.ConclusionThough ANC and early ANC initiation coverages were relatively high, the complexities in the given correlates of ANC accessibility require a multi-sectoral approach to strengthen community-based services to increase the survival of pregnant women and unborn babies.